Kari Leanne Hart, DNP, FNP

Individual provider Active NPI Nurse Practitioner · Bethalto, IL

NPI 1760131957 · NPPES record last updated Jun 23, 2022

Key facts

NPI
1760131957
Entity type
Individual (NPI type 1)
Primary specialty
Nurse Practitioner 363L00000X
License
209025060 (IL)
Practice address
163 E Bethalto Dr
Bethalto, IL 62010-1801
Phone
(618) 433-6640
Fax
(618) 433-6645
NPI assigned
Mar 23, 2022
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Heights Medical Group SC (448 clinicians)

Practice addresses (Care Compare)

163 E Bethalto Dr
Bethalto, IL 62010-1801
Phone (618) 433-6490

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20220707002406 IL Practitioner - Nurse Practitioner 8022498054 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
209025060ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Heights Medical Group SC Current
since Jul 1, 2022
Accepting new patients
Fairview Heights Medical Group SC Current
since Jul 1, 2022
Accepting new patients

Locations

1 Memorial Dr
Alton, IL 62002
Phone (618) 463-7240

163 E Bethalto Dr
Bethalto, IL 62010
Phone (618) 433-6490

2122 Troy Rd
Ste 130
Edwardsville, IL 62025
Phone (618) 692-9876

660 Mason Ridge Center Dr
Saint Louis, MO 63141
Phone (314) 273-6433

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209025060 IL Yes

Addresses

Primary practice location

163 E Bethalto Dr
Bethalto, IL 62010-1801

Mailing address

163 E Bethalto Dr
Bethalto, IL 62010-1801
Phone (618) 433-6640

Electronic endpoints

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

Other providers in Bethalto, IL

All providers in Bethalto, IL · Nurse Practitioner in Illinois

Sources for this page

Verify at the official NPI Registry.